TRICIA M MIEDEMA (NPI# 1023390507) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023390507 |
| Entity Type | Individual |
| Full Name | TRICIA M MIEDEMA |
| Credential | PA-C |
| Practice Address |
200 N Park St Kalamazoo MI 49007-3731 |
| Practice Telephone | 2693822500 |
| Practice Fax Number | 2693730123 |
| Mailing Telephone | 2693822500 |
| Mailing Fax Number | 2693730123 |
| Enumeration Date | 2011-09-12 |
| Last Update Date | 2013-01-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 5601006114 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 1023390507 | 05 | |
| MI | BCBSM - WMCC | 1588778484 | 01 |
| Street Address |
200 N PARK ST |
| City | KALAMAZOO |
| State | MI |
| Zip Code | 49007-3731 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427051200 | Joseph Mirro Jr. | Pediatrics | 200 N Park St, West Michigan Cancer Center, Kalamazoo, MI 49007-3731 | 2005-05-24 |
| 1770105553 | Kathryn Barnett | Nurse Practitioner | 200 N Park St, Kalamazoo, MI 49007-3731 | 2020-05-14 |
| 1528618725 | Mallory Davis | Social Worker | 200 N Park St, Kalamazoo, MI 49007-3731 | 2019-09-19 |
| 1710498290 | Chelsea Ashcraft | Physician Assistant | 200 N Park St, Kalamazoo, MI 49007-3731 | 2017-10-24 |
| 1336650431 | Kaitlyn Mcgrail | Physician Assistant | 200 N Park St, Kalamazoo, MI 49007-3731 | 2017-10-16 |
| 1215394580 | Stephen Paul Rucker | Physician Assistant | 200 N Park St, Kalamazoo, MI 49007-3731 | 2016-01-18 |
| 1831566637 | Timothy Craig Nicaise Jr. | Nurse Practitioner | 200 N Park St, Kalamazoo, MI 49007-3731 | 2015-08-27 |
| 1730506510 | West Michigan Cancer Center | Pharmacy | 200 N Park St, Kalamazoo, MI 49007-3731 | 2014-03-18 |
| 1841624483 | Michael Thomas Francisco | Physician Assistant | 200 N Park St, Kalamazoo, MI 49007-3731 | 2013-08-31 |
| 1730463597 | Julie Ann Digiovanni | Clinical Nurse Specialist | 200 N Park St, Kalamazoo, MI 49007-3731 | 2011-09-28 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881248342 | Whitney Kiel | Pharmacist | 601 John Street Suite M-020, Kalamazoo, MI 49007 | 2019-08-01 |
| 1316591571 | Laura Jedele | Physical Therapist | Bronson Healthcare Group, 601 John St, Kalamazoo, MI 49007 | 2019-07-26 |
| 1992209084 | Yvonne Marie Heltzel | Behavior Technician | 1826 N Rose St, Kalamazoo, MI 49007 | 2018-03-22 |
| 1396263943 | Travis Todd Turrell | Physician Assistant | 125 S Kalamazoo Mall Suite 204, Kalamazoo, MI 49007 | 2017-09-05 |
| 1619493186 | Sarah Zuspann | Nurse Practitioner | 601 John Street, Suite 100, Kalamazoo, MI 49007 | 2017-08-16 |
| 1720529779 | Dannison | Psychologist | 604 S Rose St, Kalamazoo, MI 49007 | 2017-03-10 |
| 1265988901 | Calee Dieleman | Social Worker | 610 South Burdick, Kalamazoo, MI 49007 | 2016-09-01 |
| 1508313099 | Arriel Julia Ampey | Social Worker | 414 S. Burdick St., Suite 200, Kalamazoo, MI 49007 | 2016-09-01 |
| 1043662745 | Holloway Marston | Psychologist | 717 W South St, Apt. #6, Kalamazoo, MI 49007 | 2016-07-06 |
| 1205280062 | Bronson At Home | Home Health | 601 John St Ste M-431, Kalamazoo, MI 49007 | 2016-04-19 |
| Find all providers in zip 49007 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013516194 | Rebecca Mary Cronin | Physician Assistant | 4311 Kingsbrook Dr, Kalamazoo, MI 49006-3909 | 2020-10-20 |
| 1619574654 | Conor Mccabe | Physician Assistant | 2413 Logan Ave, Kalamazoo, MI 49008-3949 | 2020-10-02 |
| 1134766942 | Scott E Boyd | Physician Assistant | 8071 N 6th St, Kalamazoo, MI 49009-8808 | 2019-12-01 |
| 1720566847 | Lydia Chardel Bruenjes | Physician Assistant | 6565 W Main St #100, Kalamazoo, MI 49009-9199 | 2018-07-31 |
| 1396263943 | Travis Todd Turrell | Physician Assistant | 125 S Kalamazoo Mall Suite 204, Kalamazoo, MI 49007 | 2017-09-05 |
| 1467901892 | Brian Christopher Rensch | Physician Assistant | 916 Austin St, Kalamazoo, MI 49008-1105 | 2016-09-27 |
| 1427415462 | Katelyn Vasicek | Physician Assistant | 601 John St Ste M-302, Kalamazoo, MI 49007 | 2016-01-21 |
| 1598168874 | Melissa Shields | Physician Assistant | Western Michigan University, 1903 Western Michigan Avenue, Kalamazoo, MI 49008 | 2014-10-01 |
| 1700291549 | Lauren Gilbertson | Physician Assistant | 1722 Shaffer St Ste 3, Kalamazoo, MI 49048-1633 | 2014-06-30 |
| 1447445002 | Jennifer Hurtt | Physician Assistant | 1541 Gull Rd Ste 200, Kalamazoo, MI 49048-1644 | 2007-09-07 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.